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   2020| January-June  | Volume 15 | Issue 1  
    Online since June 29, 2020

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Evaluation of cord blood alkaline phosphatase as a predictor of hyperbilirubinemia in Egyptian neonates
Sally R Eid, Amal G Mohamed, Heba T Okda, Hala M Abdel Salam
January-June 2020, 15(1):11-17
Background/aim Hyperbilirubinemia is a major cause of neonatal morbidity. It affects nearly 60% of term and 80% of preterm neonates during the first week of life. Early prediction of hyperbilirubinemia will help in early discharge and prevent hospitalization of babies and mothers for longer periods. The aim of this study was to verify whether the cord alkaline phosphatase (ALP) levels can predict the development of neonatal hyperbilirubinemia. Participants and methods This prospective study was conducted at Alglaa Teaching Hospital from June 2016 to May 2018. A total of 200 healthy term and late preterm neonates meeting the inclusion criteria were enrolled in this study (gestational age >35 weeks of either sex, from any mode of delivery, and Apgar score ≥7 at first and fifth minutes of life). After birth, cord blood was collected for the estimation of cord blood ALP and serum total bilirubin. Results The incidence of clinical jaundice in our study was 50.54% (94 cases). Only 28.72% (27 cases) of them required treatment. There is a significant association between cord blood ALP levels and the development of hyperbilirubinemia requiring treatment. Receiver operating characteristic curve analysis demonstrates that ALP level of the cord blood greater than 342 IU/l was the most appropriate cutoff value for predicting significant jaundice (that needs treatment). It was associated with 91.07% sensitivity and specificity 61.54%. The area under the curve was 0.791, indicating the high significance and the usefulness of this assay in predicting significant jaundice requiring medication. Conclusion This study concludes that cord blood ALP levels reliably predict the occurrence of pathological hyperbilirubinemia requiring therapy as defined by the current operational guidelines.
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Clinical and molecular correlation of hepcidin RNA expression in sickle cell patients with iron overload
Eman H Thabet, Eman A Albostany, Neveen A Helmy, Sonia A Habib, Solaf A Kamel, Neveen Salama, Shereen H Abd El Aziz, Eman ElTahlawy, Eman A Elghoroury
January-June 2020, 15(1):1-5
Background/aim Iron overload is the main concern in treatment of hemolytic diseases with repeated blood transfusion, especially sickle cell disease (SCD). Hepcidin has appeared as the key iron metabolism regulator. Erythroferrone (ERFE) is postulated to function as the chief erythroid regulator. Transferrin receptor 2 (TfR2) acts as an iron sensor on erythroid cells. Our aim is to evaluate serum levels of hepcidin, ferritin, ERFE, and TfR2 and its correlation with molecular genetic study of hepcidin gene expression for SCD patients Patients and methods Patients: 103 children aged 6–18 years with SCD were recruited from the Pediatric Hematology Clinic at the National Research Center and Abo-Elrish Hospital (Cairo University), and 55 healthy children with matched age and sex served as the control group. Methods: laboratory analysis and enzyme-linked immunosorbent assay tests on patient samples were performed for serum hepcidin, ERFE, ferritin and TfR2, and hepcidin gene expression was performed by quantitative real-time PCR. Results Hepcidin RNA expression level showed significant correlation with the duration of the disease and blood transfusion frequency (r=−0.33, P<0.001) (r=−0.270, P 0.006), respectively. Conclusion Combination of enzyme-linked immunosorbent assay and molecular studies of hepcidin RNA expression could be a diagnostic marker to be used in conjunction with analytical techniques to detect iron overload in pediatric sickle cell disease.
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Physical activity patterns in Egyptian obese and nonobese adolescents assessed using a validated WHO questionnaire
Azza Abd El-Shaheed, Nermine N Mahfouz, Mona A Elabd, Sara F Sallam
January-June 2020, 15(1):6-10
Background/aim Obesity is one of the major health problems especially when started early in life, and is associated with serious complications. The study aimed to focus on physical activity in a sample of Egyptian obese and nonobese adolescents. Patients and methods This study enrolled 89 adolescents of both sexes from the Medical Research Centre of Excellence at Cairo, Egypt, and were divided into two groups. Group 1, the obese group which included 45 children with a BMI more than or equal to 85th centile and group 2 the nonobese group which consisted of 44 matched peers with a BMI less than 85th centile. Physical habits were determined using a validated (yes or no) questionnaire according to WHO recommendations, Results Physical activity patterns and intensity in the studied individuals according to WHO recommendations differed between obese and nonobese adolescents as 33.3% of obese adolescents were involved in 60 min of moderate to vigorous physical activity compared with 15.9% of the nonobese group with a P value of 0.057,while 35.5% of obese adolescents were involved also in daily activity of more than 60 min compared with 15.9% of nonobese adolescents. In 73.3% of the obese group, most of their physical activity is aerobic compared with 40.9% of the nonobese group with a statistically significant difference, P value of 0.002. Of the obese group 4.4% were involved in vigorous-intensity activities three times per week at least including those that strengthen the muscle and the bone. Conclusions Physical activity is a habit encountered in obese adolescents than nonobese adolescents that is reflected on their answers of the questionnaire, regarding its pattern and intensity, which is beneficial to reduce the risk of development of chronic diseases, complications resulting from obesity and assist the promotion of healthy lifestyle.
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Therapeutic and photobiomodulation effects of low-level laser irradiation on Egyptian patients with carpal tunnel syndrome: a placebo-controlled study
Aliaa Elgendy, Maha Abdelhadi Ali, Amira Medhat, Emad N Zikri, Mona M.F. Ganem
January-June 2020, 15(1):18-24
Background/Aim Carpal tunnel syndrome (CTS) is the most prevalent mononeuropathy, where the median nerve is entrapped in the hand; it affects women more than men and is diagnosed by clinical and electrophysiological examination. Low-level laser therapy (LLLT) was suggested for conservative treatment of CTS. The aim of this study was to evaluate the role of LLLT in the treatment of CTS. Patients and methods The study was carried out on 40 female patients with CTS. Patients were recruited from Neurology and Rheumatology clinics at National Research Centre, Egypt. The patients were randomly divided into two groups (20 patients each). The first group was subjected to active LLLT, and the second group was subjected to placebo (sham) LLLT. The patients of the first group were treated with real LLLT by gallium-aluminum-arsenide laser (905 nm) with touch sensor guide light +8 diodes of power output of 100 MW each (800 MW total), and pulsed mode of frequency of 10 000 Hz over two areas, one extends from the proximal palmer crease to the distal wrist crease and the other over the thenar area, for three times per week for 4 weeks (12 sessions). All patients were subjected to clinical and nerve conduction studies evaluations. Results LLLT showed significant reduction in erythrocyte sedimentation rate and visual analog scale and significant improvement in functional status scale and symptom severity scale (P<0.05) in real laser exposed group when compared with sham laser exposed group. In addition, there was a significant reduction of the sensory (P<0.05) and motor latencies (P<0.05) and also significant improvement of sensory (P<0.05) and motor amplitudes (P<0.05), as well as sensory (P<0.05) and motor velocities (P<0.05) of median nerve conduction studies in real laser exposed group when compared with sham laser exposed group. Conclusion This study confirmed the safety and positive effects of LLLT on pain, inflammation, functional capacity, and electro-neurophysiological aspects of median nerve in patients with CTS.
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